Friday, August 22, 2008

Medical Malpractice and the Courts

"Medical circles breathed a sigh of relief Wednesday over the Fukushima District Court's decision to acquit the obstetrician at the center of a case involving professional negligence resulting in death.

""The ruling is reasonable because it shows the court understands the difficulties and risks involved in the treatment of patients who are in a critical condition," the Japan Society of Obstetrics and Gynecology (JSOG) said.

"In a statement, the society said it had made strong overtures to prosecutors not to appeal the ruling so as to avoid causing further confusion in the medical community over the trial.

"Doctors and others had been particularly critical of the decision by police to pursue criminal charges against Katsuhiko Kato, 40, whose patient died after he performed a Caesarean section in 2004.

""The ruling was what the medical community had been longing for," said an obstetrician and gynecologist at a university hospital.

"According to the Ministry of Health, Labor and Welfare, 54 women died in connection with child-bearing in 2006.

"During the trial, the central question facing the district court was this: How should doctors and other medical practitioners be held accountable when things go drastically wrong while they are trying to save their patients?

"Chizuko Kuwae, chief of the obstetrics and gynecology department at the Tokyo Metropolitan Fuchu Hospital, said that on occasion it was inevitable that patients die--despite the best efforts by their doctors.

""We would be put in the position of not being able to do anything unless these risks are properly recognized," Kuwae said.

"The number of obstetricians and gynecologists nationwide fell by 12 percent during the decade through 2006, partly due to the higher risks in this area of medicine.

"Norio Higuchi, professor of British and American law at the University of Tokyo's Graduate School of Public Policy, said the ruling made it clear that a criminal court trial is not the appropriate venue for uncovering the truth behind medical accidents.

""A new system should be established to enable doctors and patients to work together in an investigation (into a medical accident) so as to prevent a recurrence," Higuchi said.

"The ruling will likely influence a bill the health ministry plans to submit to an extraordinary Diet session in autumn to formally establish a committee of third-party experts to investigate malpractice cases.

""(The obstetrician) would not have faced criminal charges if a third-party organization of experts had been tasked with the investigation (into the case)," said Takashi Okai, an executive director of the JSOG and professor of Showa University medical school.

"Hiroyuki Nagai, who heads a citizens group working to prevent medical accidents, said a third-party organization should be set as as soon as possible to secure impartial and expert investigative procedures into such matters."